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Immune Mediated Polyarthritis


Danois
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Angus has been recently diagnosed with Immune Mediated Poly Arthritis (IMPA from now on in!) and I am just wanting to hear from anyone else who has had this diagnosed as we are having a few teething problems with treatment - but getting there thanks to a fanstastic vet (and vet nurse!).

Angus is a 15 month old great dane.

The background is that I had Angus had the vet 4 or 5 times in the first 10 months with a limp (predominantly in right hind but did shift for a period) and stiffness. His right hock was swollen. In July he had a fever and spent the day in hospital on anti-biotics and anti-inflamms. He returned a high white blood cell reading but his temp came down with treatment and he was discharged with a diagnosis of pyrexia (fever of unknown origin). His bloods were not retested by the vet.

Up until then he had been gaining weight steadily and weighed 45kg aged 8 months. Since July he has put on less than 10kgs and is currently around 53kg. (His brother weighed 68kg at 12 months).

The vets were determined from day one it was OCD.

Just prior to Xmas he was limping again and his right hock was very swollen - went to the usual vets and again decided it was OCD. They declined to do a fluid tap as highly sterile conditions were necessary and they could not do it there. Was given rimadyal and told to go back in a week if still swollen.

After talking with another vet/nurse I went for a second opinion - a fluid tap was done on the spot which came back with a very high white blood cell count. Bloods and xrays were done and a diagnosis of IMPA was made.

Angs was started on a course of prednisolone (cortisone) of 100mg a day. Unfortunately after 2.5 weeks there was no consistent improvement and despite being on cortisone was not eating very much at all. He is blessed with the common dane sensitive stomach and he had the runs oon and off.

Fresh bloods and fluid tap showed a white blood cell count of 32,000 which was increased despite the cortisone. No bacterial organisms were found to indicate infection.

We tapered the cortisone back and he seemed to respond by eating really well and reduced swelling. He had dropped 3kg or so by this time.

Unfortunately (again!) it flared back again and since mid week he has been back on the high dose of cortisone and also on Imuran too. In a couple of days the swelling has reduced significantly but again, he does not have much of an appetite. Hopefully he holds his weight.

When he is eating he is having 5 cups of RC Giant Junior twice a day plus 500g or so of mince for supper. He also has fish oil and I mix Thrive d through his food as he gets bad gas and it aids with digestion. He cannot have lamb flaps or roo as it is too rich for his stomach.

He has been such a trooper - he just stands there and lets the vet stick needles in, rotate joints etc - they only had to sedate him for the xrays rather than GA. I am very proud of my boy but it is very hard to see him unhappy.

So - thats Angs story and I would really appreciate if anyone else has any experience with IMPA, having a dog on cortisone and/ or imuran and anything else anyone can offer!

Thanks in advance.

Sarah & Angus

Edited by MCM
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Ditto to dogbesotted- a holistic Vet may also be able to help with the tummy upsets.

I would also look down the Chiro and muscle treatment path too, just to rule it out of the equation. :wave:

Process of elimination now and finding what treatments work best for him.

Edited by Staff'n'Toller
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Poor Angus has been in the wars!

I'm afraid I haven't heard of the condition, but just wanted to say that you seem to be doing everything right by Angus. It's amazing that these dogs of ours can be so tolerant to being poked and prodded when they know it will help them.

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Thanks guys for your words and the links.

I had a fantastic day today - he has put on 4kg this week and is now at the heaviest he has ever been and the swelling has gone down by about 2/3rds since we started the new meds this week (response time is very quick). Bad news is that his poor tummy is upset and I am going to remain him Squirt...

27Jan013.jpg

(Just in case you 'avoid' the dane thread!)

Edited by MCM
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Thanks Oakway - I will look into that.

It has not been the best weekend - he has had diarrohea most of the weekend - pure liquid despite being fasted and then fed i/d and chicken/rice/pumpkin. Everything is irritated so he has blood in the poo.

Despite this he is hungry but no food for him!

We've stopped his medication for now too.

Its very hard - everytime we seem to make progress we then come to a grinding halt.

(I should note I have had vet advice).

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Regular vet using knowledge from the specialist.

The frustrating thing is that the cortisone and Imuran were working and he had been on them for 3 days before he got the runs. The swelling in his hock at come down by about 2/3rds. I do not know if the runs was because of something he ate or whether it is just too harsh for his stomach.

I am speaking with the vet again in the morning and I think specialist is our next option.

All I can say is thank doG for pet insurance!

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Yay - we are back on track! Seems like something upset his stomach and as a result of the drugs his body found it harder to shake than usual.

I was so happy to see a very orange poo tonight!

He is still trying to tell me he is owed some food from the last couple of days!

Does not appear that coming off the drugs for a day or so has caused a flare up which is great!

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Hi MCM,

My greyhound Poppy (avatar) has Autoimmune Polyarthritis too. We went through her heavy cortisone treatment about 2.5 yrs ago. She was on a very heavy dose initally, and then it was slowly tapered off over 3 months until she came off it.

Took us 3 months and numerous vets to get her a diagnosis. I had one vet diagnose a spinal infection and told me to put her to sleep!

Poppy was unusual in that she didn't show any joint swelling until after she had been admitted to the vets because she could no longer stand because of the pain.

She's had 2 small relapses since then, but a 2 week course of cortisone has fixed that no problems.

Good luck with your boy, and if you want to pm me feel free ;)

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Well we seem to be progressing okay at the moment - touch wood!

We have been able to taper the Imuran back to once every 2nd day. He is still on the cortisone (2.5 tabs twice daily).

There has been a substantial reduction in the swelling in the hock but there is still a little there. He also has a warm spot on his spine.

He continues to drink - I have upgraded his water bowl to a bucket (those low wide ones). He has not displayed the appetite expected on cortisone but he is continuing to at least maintain his weight.

Here are the pics of his hock:

16Dec026.jpg

16 Dec

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11 Jan

14Jan001.jpg

14 Jan

19Jan015.jpg

19 Jan

3Feb007.jpg

3 Feb

13feb001.jpg

13 Feb - Yay!

Edited by MCM
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Hi all,

I've never really posted to this before so apologies if it's all out of whack.

My Toller has had IMPA for over a year now. She was very sick, lethargic and sick when the symptoms first appeared and it took us around 3 months to finally diagnose it. We used an ANA test and some joint taps, as well as numerous blood tests.

So she's been on Cortisone (the blue tablets) since March 07 and came off them Nov 07. She did very well on the cortisone and even managed to win a stack of agility comps. The only side effect was dry skin and loss of coat.

After she went off the cortisone, she was doing good for a month or so but as of Jan started to show signs of stiffness. Got an ANA test done again and got back another positive result. So now i'm waiting to hear back from the specialist in Melbourne about how to treat it this time. Would love to share ideas on treatments (especially any homeopathic treatments) that anyone is using.

Look forward to keeping in touch via this forum.

Deb Owen and Ghillie

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